Abstract
Abstract P94: Rural-Urban Utilization of Echocardiography: Analysis of Veterans Administration Data
Circulation Cardiovascular quality and outcomes, Vol.4(suppl_1)
11/2011
DOI: 10.1161/circoutcomes.4.suppl_1.AP94
Abstract
BACKGROUND:
Patients residing in rural areas may have reduced access to many medical services. This is a particular concern for highly regionalized delivery systems such as VA Healthcare System. We examine echocardiography (echo) utilization among veterans residing in urban and rural regions of the US.
METHODS:
We used VA administrative data to identify patients receiving care at the VA from 1999-2007. Patients were included during any year that they were engaged in care at the VA, defined by having at least 2 primary care visits during the year (“VA users”). For each year, we identified echos performed on VA users using CPT or ICD-9 codes. We classified each veteran as living in an urban, rural or highly rural region using the RUCA classification system. We compared demographics, comorbidity, and echo utilization rates per 1000 VA users among veterans living in each of the 3 regions using bivariate methods. We used logistic regression models to compare echo utilization for veterans residing in rural and highly rural areas with urban veterans serving as the reference while adjusting for patient demographics, comorbidity, and clustering of patients within 23 veteran integrated networks.
RESULTS:
Echo recipients residing in highly rural areas were older than residents in rural and urban areas (67.3 yrs vs. 66.7 yrs vs. 66.6 yrs), and more likely to be white, (76.5% vs. 73.6% vs. 59.4%). Unadjusted echo utilization was significantly higher for residents of urban areas compared to rural areas, but similar to highly rural areas (64.0 echos per 1000 per year for urban vs. 59.2 for rural vs. 63.7 for highly rural). In regression models however, we found that veterans living in rural and highly rural areas were slightly more likely to receive echos compared to veterans living in urban areas after adjusting for patient demographics and comorbidity (OR 1.03 95% CI 1.03-1.04 for rural and OR 1.13 95% CI 1.12-1.14 for isolated rural).
CONCLUSION:
We found no evidence that veterans residing in rural and highly rural regions of the U.S. had reduced utilization of echocardiography after adjusting for patient demographics and comorbidity. These findings suggest that the regionalization of the VA delivery system does not limit the performance of echocardiography for rural veterans.
Details
- Title: Subtitle
- Abstract P94: Rural-Urban Utilization of Echocardiography: Analysis of Veterans Administration Data
- Creators
- Kingston Okrah - University of IowaMary Vaughan-Sarrazin - University of IowaPeter Kaboli - University of IowaPeter Cram - University of Iowa
- Resource Type
- Abstract
- Publication Details
- Circulation Cardiovascular quality and outcomes, Vol.4(suppl_1)
- DOI
- 10.1161/circoutcomes.4.suppl_1.AP94
- ISSN
- 1941-7713
- eISSN
- 1941-7705
- Language
- English
- Date published
- 11/2011
- Academic Unit
- Epidemiology; Health Management and Policy; General Internal Medicine; Internal Medicine
- Record Identifier
- 9984363450402771
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